Apo-Desvenlafaxine Drug Interactions

Do not use APO-DESVENLAFAXINE if taking or have recently taken monoamine oxidase inhibitors. Do not take APO-DESVENLAFAXINE with a MAOI or within 14 days of stopping a MAOI. Taking a MAOI together with many prescription medicines, including APO-DESVENLAFAXINE, can cause serious or even life-threatening side effects. Also, waiting at least 7 days is needed after taking APO-DESVENLAFAXINE is stopped before taking a MAOI.
Certain laboratory results may be affected by use of APO-DESVENLAFAXINE. Discuss with the doctor if any unusual lab reports are received.
Tell the doctor if taking or have recently taken any medications (prescription, non-prescription, or natural/herbal), especially: Monoamine oxidase inhibitors (MAOI) including linezolid, an antibiotic, and methylene blue, a dye used in certain surgeries; Certain medicines which may affect blood clotting and increase bleeding, such as oral anticoagulants (e.g. warfarin, dabigatran), acetylsalicylic acid (e.g. aspirin) and other non-steroidal anti-inflammatory drugs (e.g. ibuprofen); Medicines containing venlafaxine or other medicines containing desvenlafaxine.
Serotonin syndrome or a neuroleptic malignant syndrome (NMS)-like reactions: Rare, but potentially life-threatening conditions called serotonin syndrome or NMS-like reactions can cause serious changes in how the brain, muscles and digestive system work and can happen when medicines like APO-DESVENLAFAXINE are taken, particularly when taken with certain other medications such as: medicines to treat migraine headaches known as triptans; medicines used to treat mood or thought disorders, including tricyclics, lithium, selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), or dopamine antagonists, including antipsychotics; amphetamines; sibutramine; certain medicines used to treat pain, such as fentanyl (used in anaesthesia or to treat chronic pain), tramadol, tapentadol, meperidine, methadone, pentazocine; certain medicines used to treat cough, such as dextromethorphan; St. John's Wort; MAOIs (including linezolid, an antibiotic, and methylene blue, a dye sometimes injected before surgery to guide the surgeon); tryptophan supplements.
Before APO-DESVENLAFAXINE and any of these medicines are taken together, talk to the healthcare professional about the possibility of serotonin syndrome or NMS-like reactions. Signs and symptoms of serotonin syndrome or NMS may include a combination of the following: Agitation (excitability, restlessness), hallucinations, confusion, loss of coordination, muscle twitching or stiffness, fast heartbeat, increased body temperature, fast changes in blood pressure, overactive reflexes, diarrhea, coma, nausea, vomiting. Get medical care right away if suspecting that serotonin syndrome is happening.
Central nervous system drugs: Caution is advised when APO-DESVENLAFAXINE is taken in combination with other centrally acting drugs or substances, including alcohol and sedative drugs (benzodiazepines, opiates, antipsychotics, phenobarbital, sedative antihistamines). Inform the doctor if taking any of these drugs. Avoid alcohol while taking APO-DESVENLAFAXINE.
Switching from other antidepressants: Side effects from discontinuing antidepressant medication have occurred when patients switched from other antidepressants, including venlafaxine, to APO-DESVENLAFAXINE. The doctor may gradually reduce the dose of the initial antidepressant medication to help to reduce these side effects.